Recent advances in surgical techniques have made possible correction of major craniofacial anomalies. These procedures have been justified on the basis of assumed psychosocial benefits believed to be derived from improved appearance. To date, there has been little documentation of either the presurgical psychological and social functioning of these patients or of any changes in this functioning that might follow surgery. This study will be directed toward objectively evaluating pre and post surgical psychosocial status. Patients between 7 and 13 years of age with congenital craniofacial anomalies will be evaluated prior to surgery, one year later and in some cases also two years later. Matched groups of patients undergoing surgery for congenital cardiac defects and healthy pediatric patients will also be evaluated for purposes of comparison. Measures used will reflect self-concept, social relationships, school adjustment, behavioral difficulties, affective problems, and family environment. Major goals of the study include: (1) assessment of presurgical psychosocial status of craniofacial subjects relative to the two comparison groups, (2) assessment of change in psychosocial status of the craniofacial subjects following surgery relative to the two comparison groups, (3) determination of the influence of appearance in the psychosocial adjustment of craniofacial patients, (4) identification of possible patterns of psychosocial difficulties not improved by surgery alone. It is the intent of the investigators to generate much needed information for craniofacial patients, their families and doctors concerning what can and cannot be achieved in the way of psychosocial changes through surgery.